Effect of spironolactone intake on the circadian rhythm of blood pressure in patients with resistant hypertension: a retrospective cohort study

• Grant number: 17/13990-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: November 01, 2017
• End date: October 31, 2018
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Heitor Moreno Junior
• Grantee: Pedro Henrique Benfatti Gomes
• Host Institution: Faculdade de Ciências Médicas (FCM). Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

Resistant Hypertension (RHTN) is defined as blood pressure (BP) that remains above goal (SBP e 140mmHg and/or DBP e 90mmHg) in spite of the concurrent use of 3 antihypertensive agents of different classes prescribed at optimal doses and ideally, one of the 3 agents should be a diuretic. It has complex physiopathological mechanisms that are not completely elucidated, which makes it a disease hard to control. It is also known that this group of patients have higher risk of developing cardiovascular disease, because they are most likely to have uncontrolled BP. In addition, most of the researches corroborates that the incidence of cardiovascular events are more likely to occur during the second quarter of the day (6:01 - 12:00), due to the interaction of both intrinsic and extrinsic mechanism. Studies have established spironolactone as the best fourth-line drug to manage RHTN. It is a diuretic with important BP-lowering effect that also works as a cardiovascular protector due the antagonism of aldosterone. The purpose of this project is to identify how long it takes to spironolactone reach the peak of its hypotensive effect once it is taken. Thus, we might be able to optimize the dosage and therapeutic scheme, in order to achieve the peak of BP-lowering effect during the second quarter of the day. Therefore, it may prevent cardiovascular events directly connected with high BP levels. Ultimately, it will discharge the Brazil's Unified Public Health System (SUS) and give better life quality to the patients. (AU)